Individual provider Active NPI

Laura Lynn Moroney

  • Nurse Practitioner
  • Rancho Mirage, CA
National Provider Identifier
1184100265
Registry record updated Sep 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95004453 Issued in CA
Practice address
42600 Mirage Rd
Rancho Mirage, CA 92270-4127
Phone
(760) 423-4000
Fax
(760) 318-8103
NPI assigned
Jul 12, 2018
Last updated
Sep 9, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 95004453 CA Primary

Addresses

Primary practice location

42600 Mirage Rd
Rancho Mirage, CA 92270-4127

Mailing address

42600 Mirage Rd
Rancho Mirage, CA 92270-4127
Phone (760) 423-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, MP2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190521003425 CA Practitioner - Nurse Practitioner 8325381056 Reassigns benefits to 1 organization
I20210401002277 MP Practitioner - Nurse Practitioner 8325381056 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Contour Dermatology and Cosmetic Surgery Medical Center, Apc CurrentSince Feb 6, 2019 Accepting new patients
Medical Associates of the Pacific LLC CurrentSince Apr 14, 2021 Accepting new patients

Locations

46080 Jefferson St
La Quinta, CA 92253
Phone (760) 423-4000

42600 Mirage Rd
Rancho Mirage, CA 92270
Phone (760) 423-4000

42600 Mirage Rd
#A1
Rancho Mirage, CA 92270

42600 Mirage Rd
Ste A1
Rancho Mirage, CA 92270
Phone (760) 416-6971

Interoperability endpoints

  • Direct secure messaging: lmoroney@directaddress.net
  • Direct secure messaging: lmoroney1@puyallupderm.emadirect.md

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1531353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599609600000",
    "number": "1184100265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42600 MIRAGE RD",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922704127",
            "telephone_number": "760-423-4000",
            "fax_number": "760-318-8103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42600 MIRAGE RD",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922704127",
            "telephone_number": "760-423-4000",
            "fax_number": "760-318-8103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORONEY",
        "first_name": "LAURA",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-12",
        "last_updated": "2020-09-09",
        "certification_date": "2020-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95004453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Mirage, CA

Sources for this page

Verify at the official NPI Registry.